Duplex imaging and incidence of carotid radiation injury after high-dose radiotherapy for tumors of the head and neck
M. W. Moritz, R. F. Higgins and J. R. Jacobs
Department of Surgery, Wayne State University, Detroit, Mich.
Radiation-induced carotid artery disease following high-dose (greater than
50-Gy) radiotherapy for head and neck cancer may become more common as
improved treatment results in longer survival. Duplex ultrasound scans were
obtained in 91 consecutive patients to determine whether increased
incidence and severity of extracranial carotid disease correlate with prior
radiotherapy. Fifty-three patients who underwent radiotherapy an average of
28 months previously and 38 patients who received no radiotherapy were
studied. Thirty percent of the irradiated group had lesions of the carotid
arteries that were either moderate or severe vs only 6% of the control
patients. Five patients were symptomatic; all had undergone radiotherapy.
Long-term follow-up with sequential duplex ultrasound examinations is
indicated in patients receiving high-dose radiotherapy for head and neck
tumors, to detect radiation-induced carotid artery disease and prevent late
sequelae.
